Congenital radio-ulnar synostosis: compensatory rotation around the wrist and rotation osteotomy.

In order to make clear the clinical features of congenital radio-ulnar synostosis, compensatory rotation around the wrist and functional results after rotation osteotomy, 40 cases of congenital radio-ulnar synostosis have been analysed. The mean pronation of the ankylosed forearm in those who complained of disabilities in daily life was 60.7 degrees and that in patients without complaints was 21.2 degrees. In almost all cases with total ankylosis, the forearm had compensatory movement around the wrist, the mean arc being from 76.3 degrees of pronation to 42.9 degrees of supination. 13 limbs in 11 patients treated by transverse rotational osteotomies through the fusion mass have followed up for over two years. The functional results after surgery were satisfactory in all patients. Rotational osteotomy of the forearm is a useful and reliable treatment for congenital radio-ulnar synostosis.